Nearly every morning, before 7 a.m., Dr. Kenneth Polonsky is dropped off near the Lakefront Trail on Chicago's South Side, a few steps from Lake Michigan.

He carries no briefcase, wears no suit and has no cup of coffee, the standard trappings of his executive contemporaries.

Instead — at least in the winter — he's covered in high-tech running gear, leaving only a small patch of skin around his eyes exposed to the weather. The outfit, he muses, must raise suspicions among cab drivers.

"It's 6:30 in the morning, it's dark and can be, maybe, 10 degrees outside," he says. "When I ask the driver to drop me by the side of (the road), they must think, 'What's going on with this guy? There's something funny here.'"

Twelve months a year, through heat waves, cold snaps, rain, sleet and snow, the top official at

University of Chicago

Medicine starts most mornings running 5 miles to work.

It's a routine that reflects lessons learned from decades of studying

diabetes

and treating patients with the disease and one he pairs with watching his diet "like a hawk." The daily run also is a vehicle for the cerebral 62-year-old M.D. to contemplate the challenges that lie ahead.

There are many, starting with the massive transformation of the way medical care is paid for and delivered as part of President

Barack Obama

's 2010 health care overhaul.

Polonsky also faces cuts to research funding that flows to the Pritzker School of Medicine through the

National Institutes of Health

and growing financial pressure from Illinois'

Medicaid

program, the federal-state health insurance program that serves a substantial percentage of the hospital's South Side patients.

All this while christening and trying to pay for a $700 million, 1.2 million-square-foot new hospital, a 10-story, boxy, modernist structure that towers above a campus better known for its ubiquitous, early-20th-century red-roofed Gothic buildings.

The hospital, dubbed the Center for Care and Discovery in the absence of a donor willing to lay down $50 million for naming rights, is scheduled to open Saturday.

With 240 private patient rooms, 28 supersize operating rooms and seven advanced imaging rooms, the hospital will specialize in neuroscience and the treatment of cancer and gastrointestinal diseases.

But even what is supposed to be a celebratory, clink-the-glasses moment for Polonsky and the university has been sullied by controversy.

An estimated 50 protesters entered the hospital on a Sunday afternoon in January, holding placards and using a megaphone to voice their displeasure that such a costly facility was not outfitted with a trauma unit.

University police with batons were videotaped shoving protesters to the ground. Four were arrested in the melee.

Polonsky said the system is re-evaluating its role in trauma care, "a legitimate question for discussion and debate and one we are looking at again in detail."

Managing this issue will be a major test of Polonsky's leadership in 2013 and will occur against the backdrop of the largest upheaval to the health care industry in a generation.

"We're in a really vulnerable situation at the moment; there's no question about it," Polonsky said of the shift under way in health care. "But that's one of the reasons I'm interested in my job. I believe I can impact a series of big issues."

Many people, he said, go through life wondering whether what they're doing is worthwhile or significant in the big picture of things.

"I'm very fortunate to never, ever have had that problem," Polonsky said.

A boy in South Africa

Kenneth Samuel Polonsky was born in February 1951, the first of three children of an

orthopedic surgeon

named Bernard — whom he called "a very determined person" — and Rebecca, a homemaker, in Johannesburg, South

Africa

.

He attended a public primary school, segregated by race under apartheid, and a private Jewish day high school.

As a boy, he was a confident student and insatiably curious, devouring books on history, particularly those that offered unvarnished perspectives on his native country, said his wife of 42 years, Lydia, who met Polonsky when both were around age 12.

Determined to gain an unbiased understanding of South Africa's policy of racial segregation, a teenage Polonsky bought university-level history books to supplement his government-approved texts.

"He was incredibly smart, and he had a very healthy disrespect for authority," Lydia Polonsky said. "He was rebellious."

Her husband demurred. "I was just interested in the truth," he said.

At his high school, it wasn't unusual for his liberal, anti-apartheid activist teachers to be investigated or arrested for espousing views that didn't conform with those of the government, Lydia Polonsky said.

"You always had that feeling you were being watched. It was very uncomfortable," she said. "We always knew we were going to leave."

Her husband doesn't talk much about his time in South Africa. He does offer, however, that apartheid produced a set of "circumstances that were intolerable."

Polonsky also was determined to forge a career in medical research. Such opportunities were few in South Africa, a developing country where the main priority at the time was to provide basic health care to a largely poor population.

After he graduated from medical school at the University of Witwatersrand, he applied for positions at dozens of medical schools in the U.S. but was turned down for nearly every one — including internships at two medical schools he'd later guide in major leadership roles, the U. of C. and Washington University in St. Louis.

"I always tell students and interns that it's easier to become the dean here than it is to become an intern," Polonsky joked.

He finally landed an internship at the Edward Hines Jr. VA Hospital in Hines, and in January 1976 uprooted his wife and 9-month-old daughter to move to a small Oak Park apartment overlooking a Kentucky Fried Chicken.

The transition was not easy. Calls home to their families were $10 a minute. The apartment they could afford was meager. The winter was cold.

"We knew about the U.S. from movies, to be honest. It was gorgeous American kitchens; homes were beautiful. Everything seemed better," Lydia Polonsky said. "But when we arrived, it was such a shock."

After completing his residency in

internal medicine

at now-shuttered Michael Reese Hospital on the

Near South Side

, Polonsky was selected for a fellowship at the U. of C. in endocrinology.

Over the next 21 years, he rose steadily through the ranks, becoming chief of the endocrinology section and earning a named professorship. He authored or contributed to more than 180 published research papers, rising to become one of the pre-eminent diabetes researchers in the world.

It was also during his first stint at U. of C. that Polonsky met Dr. Graeme Bell, a fellow diabetes researcher who would become a longtime running partner and collaborator.

During daily runs, the two would devise scientific experiments and novel ways to approach problems in their research.

"It got us thinking in ways that we were not thinking by ourselves," said Bell, internationally renowned for his diabetes work. "Of course we chat about our lives a little bit, but after 3 miles, it always comes back to science. Always."

The two, along with their families, grew so close that Bell considered following Polonsky to St. Louis in 1999, when Washington University lured him away from Chicago by making him the chairman of its Department of Medicine and physician-in-chief of Barnes-Jewish Hospital.

They continued to collaborate during Polonsky's 11 years away — all the way up until Bell recommended him to U. of C. President Robert Zimmer when the top job at the medical school came open.

Once Polonsky was selected for the job among of pool of candidates, "I didn't ever seriously think of not taking it," he said.

It was the best of times …

Polonsky stepped into the job as executive vice president for medical affairs at a time of upheaval

in health care nationally and at U. of C.

A year earlier, in 2009, construction began on the new hospital — the largest facility the university ever has built — which promised to bring the most advanced medical technologies to the South Side.

Four months prior, Obama signed the health care overhaul into law, which codified a series of cuts in payments to hospitals in exchange for giving them more potential paying patients through the expansion of health insurance to eventually more than 30 million Americans.

Polonsky says the law will take a minimum of $300 million out of the hospital's budget over the next decade, and that doesn't include potential cuts to graduate medical education and the NIH, from which the school received about $185 million in grants in 2012.

Then, just days after Polonsky assumed his new position, came the Aug. 15 shooting death of 18-year-old Damian Turner, the victim of a stray bullet 3 1/2 blocks from the U. of C. Medical Center.

Rather than rush the gravely wounded Turner there, the

Chicago Fire Department

was required to drive him to the nearest Level 1 trauma center, about 10 miles away at

Northwestern Memorial Hospital

. Although the trip took only 10 minutes, activists and critics said Turner might have survived if U. of C. had a trauma center for adults.

U. of C.'s hospital admits trauma patients up to age 16 and has an emergency department for adults that takes in nearly 80,000 patients a year, though it is not equipped to treat patients with the most serious injuries.

The issue gained widespread media attention and caused a temporary uproar on the South Side, reviving a similar debate that has cropped up from time to time since 1988, when the university axed its adult trauma center because of financial and capacity constraints.

Polonsky expects the issue to be the subject of robust debate in months and years to come.

"It's a very, very complicated situation and one that we're re-evaluating," he said.

Polonsky, who lists

Nelson Mandela

among those he admires, is not shy about addressing tough topics.

"He's very direct," said Sharon O'Keefe, whom Polonsky hand-selected to be the medical center's president. "But he's not a harsh person. He's incredibly data-driven and practical, and he knows that things don't always go as planned."

Another challenge followed the trauma-care debate in close succession.

James Tyree, the former

Chicago Sun-Times

owner and chief executive of Mesirow Financial, died at the U. of C. in March 2011, partly because of a medical error during a routine procedure. Tyree, who served on the hospital's board, had been seriously ill with stomach cancer.

Polonsky counted Tyree as "a dear colleague" and said his death "was distressing on many levels."

"What was important to me was to ensure that his legacy of community service and philanthropy would live on," he said.

The U. of C. later agreed to a $10 million settlement with Tyree's estate without admitting fault. A portion of that money went toward the James Tyree Foundation and the James C. Tyree Program for Diabetes Care and Innovation.

Man of 'real simplicity'

Longtime friends and family say Polonsky is not motivated by material things, power or prestige, but rather personal achievement and conquering a challenge. Despite a healthy salary, he drives a 12-year-old Toyota (sparingly) and takes the train home at night (often.)

He's also known to lug around reusable grocery bags filled with his running clothes in the place of a briefcase, even to board meetings.

"There's a real simplicity about him," Bell said. "He's not enamored in things that aren't important. He's not like a surgeon wearing Brioni suits or driving fancy cars. He's not out there to make a statement."

Even so, Bell said, Polonsky has no trouble fitting in with those who are.

He can come across as quiet, but never shy, and is a capable but not dynamic public speaker.

"He's seen as somewhat of a man of fewer words," said O'Keefe, who also worked for Polonsky in St. Louis. "But when he does engage in conversation, people listen. Part of that is because he's just an incredible teacher."

Polonsky, who has a sign in his office that says, "Show Me The Data," is deliberate and measured — "rigorous," he says, a trait acquired from his father, who would spend hours reading the latest medical literature to prepare for surgeries.

That rigor will be necessary as the U. of C. hospital system weighs a partnership or affiliation with a number of hospitals and health systems, following a trend that's taken hold nationally and in Chicago.

"I don't think we can be alone," Polonsky said. "We're going to need to have a partnership with other organizations, and one form of partnership does not preclude another."

No matter how much the system changes, he believes there always will be a place for major research and training hospitals such as exist at U. of C., so long as those institutions are able to adapt to more financially constrained environs.

"Our job right now is to do better," he said. "My hope is that when I leave this role, whenever that is, that people will be able to say, yeah, the hospital, the biological sciences division and the Pritzker School of Medicine are a little bit better off than when he took over."

A family of immigrants: All of Kenneth's and Lydia's siblings immigrated to the U.S. after them. Kenneth's parents also came later. His mother lives in Southern California.

On running: "There's a certain equanimity that you have when you finish running. What's lacking in one's day, in general, is three-quarters of an hour to just sit and think and contemplate what the priorities should be. Running imposes that on one's day, and I think it's a critical element in whatever success I've been able to have in my career."

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